Anxiety gender gap: Are women really more anxious than men?

Nervous Nellies

Girls don't start out more anxious than boys, but they usually end up that way.

In the jittery world of anxiety research, one of the field's most consistent findings is also perhaps its biggest source of controversy: Women, according to countless studies, are twice as prone to anxiety as men. When pollsters call women up, they always confess to far higher levels of worry than men about everything from crime to the economy. Psychologists diagnose women with anxiety disorders two times as often as men, and research confirms—perhaps unsurprisingly—that women are significantly more inclined toward negative emotion, self-criticism, and endless rumination about problems. From statistics like these, some have even leapt to the Larry Summers-esque claim that women are simply built to be much more nervous than men—an idea that has outraged many women inside (and outside) the psychology community.

According to new evidence, however, the outraged are right: When it comes to our preconceived notions about women and anxiety, women are unfairly being dragged through the mud. While women are indeed more fretful than men on average right now, this difference is mostly the result of a cultural setup—one in which major social and parenting biases lead to girls becoming needlessly nervous adults. In reality, the idea that women are "naturally" twice as anxious as men is nothing more than a pernicious illusion.

Before we can unleash the vengeance of the furies on this falsehood, though, there's some bad news we need to get out of the way first: a few recent studies have indicated that the hormonal differences between the sexes really do make women a touch more biologically inclined toward anxiety than men. One noteworthy experiment from last year, for example, found that female brains—well, female rat brains—get more rattled by small levels of a major stress hormone called corticotrophin-releasing factor than male brains. Another 2010 study, at Florida State University, likewise revealed that male rats' higher testosterone levels seem to give them a larger buffer against anxiety than female rats have. (Don't get hung up on the fact that these studies were on rodents; most of what we know about the neuroscience of fear actually comes from tormenting lab rats.) Just how big a role these biological factors play in human women's anxiety isn't yet clear.

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But one thing we do know for certain is that the way we raise children plays a huge role in determining how disposed toward anxiety they are later in life, and thus the difference in the way we treat boys and girls explains a lot about the heightened nerves we see in many adult women. To show just how important this is, let's start at the very beginning. If women really were fated to be significantly more anxious than men, we would expect them to start showing this nervousness at a very young age, right? Yet precisely the opposite is true: According to the UCLA anxiety expert Michelle Craske, in the first few months of infants' lives, it's boys who show greater emotional neediness. While girls become slightly more prone to negative feelings than boys at two years (which, coincidentally, is the age at which kids begin learning gender roles), research has shown that up until age 11, girls and boys are equally likely to develop an anxiety disorder. By age 15, however, girls are six times more likely to have one than boys are.

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Why the sudden gap in diagnosed anxiety? Well, one answer is that as a flood of adolescent hormones sends these boys' and girls' emotions into overdrive, the difference in their upbringings finally catches up with them. After all, whether parents intend to or not, they usually treat the emotional outbursts of girls far differently than those of boys. "From a socialization angle, there's quite a lot of evidence that little girls who exhibit shyness or anxiety are reinforced for it, whereas little boys who exhibit that behavior might even be punished for it," Craske told me.

In my book Nerve, I call this the "skinned knee effect": Parents coddle girls who cry after a painful scrape but tell boys to suck it up, and this formative link between emotional outbursts and kisses from mom predisposes girls to react to unpleasant situations with "negative" feelings like anxiety later in life. On top of this, cultural biases about boys being more capable than girls also lead parents to push sons to show courage and confront their fears, while daughters are far more likely to be sheltered from life's challenges. If little Olivia shows fear, she gets a hug; if little Oliver shows fear, he gets urged to overcome it.

The result of these parenting disparities is that by the time girls grow into young women, they've learned fewer effective coping strategies than their male counterparts, which translates to higher anxiety. The sexes learn to deal with fear in two very different ways: men have been conditioned to tackle problems head-on, while women have been taught to worry, ruminate, and complain to each other (hey, I'm just reporting the research) rather than actively confront challenges. These are generalizations, of course; the fact that I have always been an Olympic-caliber worrier offers us just one example of how men can fret with the best of them, and everyone knows at least one woman who appears not even to know what fear is. Still, these differences in upbringing clarify quite a bit about the gender gap in anxiety.

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Yet parenting doesn't tell the full story of feminine nerves, because even if a young woman emerges from childhood as a relatively cool and resilient adult, she still has to do battle with social forces that seem bent on making her anxious. You may expect me to dwell here on the viselike pressure that contemporary culture exerts on women to look beautiful and young forever (one highly questionable survey found that women worry about their bodies an average of 252 times a week), but while this is a significant issue, the cultural biases about women and anxiety run deeper still.

We have an odd tendency to label women as anxious even when they aren't. A recent, highly revealing study showed that even in situations in which male and female subjects experience the same level of an emotion, women are consistently seen—and even see themselves—as being "more emotional" than men. It shouldn't be too surprising, then, that this bias holds for anxiety as well; we buy into the fretful-women stereotypes far too often. Another report, for example, found significant differences in the way doctors respond to patients who report common stress symptoms like chest pain: Whereas men get full cardiac workups, women are more often told that they're just stressed or anxious, and that their symptoms are in their heads.

It should be pretty clear by now that the claims about women being far more innately anxious than men are suspect, but before I depart in a blaze of justice, one final point is in order: Men are getting off much too easily in the anxiety discussion. Probably the most significant reason why women get diagnosed with anxiety disorders twice as often as men isn't that they're doubly fearful. It's because anxious men are much less likely to seek psychological help.

The flip side of being raised to always show strength is that men come to feel that going to a therapist is a sign of weakness or failure (think of Tony Soprano's mopey resistance to the benefits of psychiatry), which is why men constitute just 37 percent of therapy patients, by some estimates. If nearly twice as many women seek help from a psychologist, then they'll obviously be diagnosed more often with anxiety disorders. Troublingly enough, the evidence shows that while women deal with anxiety and stress by worrying, men are more likely to try to bury these feelings with alcohol or drugs—which offers one rationale for why men are at higher risk for "antisocial" disorders like alcoholism.

So take heart, women of the world: You're not necessarily bioengineered to be worry machines. The deeper truth behind the great anxiety divide is this: We all get stressed-out and nervous sometimes. Women are simply more honest about their anxiety, because they've been taught to deal with it through unencumbered fretting. Of course, I'm not about to declare that if we raised boys and girls exactly the same, eradicated the cultural anxiety bias against women, and frog-marched more men into therapy, the gender nervousness gap would magically disappear. We would almost certainly see, though, that this gap is far smaller than we think.